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The development of new antibiotics with unique mechanisms of action is paramount to combating the growing threat of antibiotic resistance. Recently, based on inspiration from natural products, an asymmetrical polyacetylene core structure was examined for its bioactivity and found to have differential specificity for different bacterial species based on the substituents around the conjugated alkyne. This research further probes the structural requirements for bioactivity through a systematic synthesis and investigation of new compounds with variable carbon chain length, alkynyl subunits, and alcohol substitution. Furthermore, the research examines the activity of the new compounds towards the inhibition of biofilm formation. Overall, several key new polyyne compounds have been identified in both decreasing bacterial viability and in disrupting pre-formed biofilms. These properties are key in the fight against bacterial infections and will be helpful in the further development of new antibiotic agents. [ABSTRACT FROM AUTHOR]

ABSTRACT. Objective. The aim of this study was to evaluate the hypothesis that prenatal cocaine exposure would negatively affect newborn behavior. Methods. A prospective observational study of term infants recruited [...]

RESUMO Objetivo: Identificar a prevalência do uso de psicofármacos entre profissionais da Atenção Primária à Saúde e os fatores associados. Métodos: Este é um estudo epidemiológico, de base populacional, transversal e analítico, realizado com 290 profissionais que atuam na Atenção Primária da Região de Saúde de Diamantina, Minas Gerais, Brasil. A coleta de dados foi realizada por meio de um questionário contendo informações sociodemográficas e econômicas, e sobre hábitos de vida, uso de medicamentos e condições de trabalho. Utilizou-se a regressão logística múltipla para obter estimativas do efeito das variáveis no uso de psicofármacos. Resultados: Observou-se prevalência de uso de psicofármacos em 10,7% (IC95%: 7-14) dos entrevistados. Entre os profissionais da Atenção Primária à Saúde, as variáveis associadas ao uso de psicofármacos foram ter idade > 31 anos ( odds ratio ajustado [ORA] = 2,33; IC95% = 1,06-5,09; p = 0,034) e ter realizado horas extras (ORA = 2,28; IC95% = 1,06-4,89; p = 0,034). Conclusão: As condições de trabalho, como carga horária excessiva, podem contribuir para o adoecimento e, consequentemente, a necessidade de uso de psicofármacos por profissionais de saúde. Assim, é importante abordar a questão, desde a assistência à saúde até o desenvolvimento de políticas de recursos humanos para o Sistema Único de Saúde (SUS) que atentem para as condições de trabalho.

O objetivo desta pesquisa é propor uma avaliação dos Sistemas de Gestão de Resíduos de Serviços de Saúde (SGRSS) e sua aplicação ao contexto de um Hospital Público Regional localizado no interior do estado de São Paulo, Brasil. A metodologia adotada na pesquisa foi um estudo de caso, do tipo exploratório e de ordem qualitativa. Sua relevância é atestada, pois vai além da dimensão operacional que é comumente abordada em outras pesquisas, agregando, assim, as dimensões administrativa, ambiental e financeira. Para tanto, apresenta-se variáveis e indicadores em uma avaliação integrada à sua aplicabilidade gerencial. Os resultados indicam que o SGRSS do Hospital Público estudado necessita ser aperfeiçoado, tendo a dimensão operacional, bem como seu modelo preponderante, uma maior relevância gerencial. A contribuição desta pesquisa, ancorada nas informações dos modelos de avaliação encontrados na literatura, recai sobre a aplicação de um modelo de Avaliação dos Sistemas de Gestão de Resíduos de Serviços de Saúde mais abrangente, assim como no direcionamento para o Gerenciamento integrado de resíduos nas organizações hospitalares, que servirá como instrumento de avaliação para os gestores no sistema de Gestão dos RSS.

O aparecimento do diabetes mellitus tipo 2 está relacionado com vários eventos, sendo o excesso de peso uma das principais causas para essa enfermidade. Neste contexto, objetivou-se identificar a prevalência de excesso de peso bem como seus fatores associados em pacientes diabéticos atendidos na rede da Atenção Básica. Trata-se de um estudo transversal com dados provenientes de prontuários de pacientes portadores de diabetes atendidos nas Equipes de Estratégia de Saúde da Família situadas na área urbana de Diamantina-MG. A população estudada foi descrita, segundo as características em termos absolutos e relativos. Posteriormente, por meio da análise bivariada, avaliou-se a associação com o excesso de peso utilizando o teste do Qui quadrado, em seguida, selecionou-se as variáveis associadas ao excesso de peso para uma análise multivariada pela Regressão de Poisson. Embora tenha sido localizado 613 prontuários de pessoas portadoras de Diabetes tipo 2, apenas 196 (31,9%) atingiram o critério de inclusão, ou seja, medidas peso e altura registrados no prontuário, sendo essa a amostra incluída no estudo. O IMC médio foi de 29,1 ± 6,3 kg/m2, 62,8% dos pacientes eram idosos, e 71,4% do sexo feminino. Em relação à distribuição do estado nutricional, o excesso de peso atingiu 44% dos idosos e 82% dos adultos. No grupo estudado as mulheres e os adultos estiveram associados ao excesso de peso. Observou-se elevada prevalência de excesso de peso, estando o mesmo associado ao sexo feminino e aos indivíduos com menos de 60 anos.

ABSTRACT Objective: To evaluate the relationship between the maternal diet quality and the fatty acid composition of breast milk in the first trimester of lactation. Methods: This is an observational cross-sectional epidemiological study of nursing mothers. The data collection instruments were a semi-structured questionnaire for sample characterization and a recall of usual intake. Diet quality was assessed based on the healthy eating index (HEI). Samples of mature breast milk were obtained by hand milking. Milk fat was extracted using the Bligh-Dyer method and methylated with 0.25 mol/L sodium methoxide in methanol diethyl ether. A gas chromatograph equipped with a flame ionization detector determined the milk fatty acid profile. Pearson’s and Spearman’s correlation tests evaluated association between the variables. Subsequently, a multiple linear regression model was built and multivariate regression analysis was applied. Results: Our findings revealed an inverse relationship between the consumption of total fruits and the polyunsaturated fatty acid profile and a direct association of the intake of total fruits and total grains with monounsaturated and saturated fatty acids. Conclusions: The results of this study suggest that maternal diet quality affects the fatty acid composition of breast milk.

Os objetivos deste estudo foram identificar práticas relacionadas ao Programa Nacional de Suplementação de Vitamina A e revelar representações sociais de mães de crianças beneficiárias acerca da vitamina A, da Deficiência de Vitamina A e do programa em um município do Vale do Jequitinhonha. Foram adotadas a abordagem qualitativa e a Teoria das Representações Sociais. Realizaram-se entrevistas semiestruturadas e focalizadas em 20 mães, sendo essas entrevistas submetidas à análise de conteúdo temática. Este estudo mostrou que a suplementação de vitamina A tem sido uma estratégia vinculada ao Programa Nacional de Imunização e que a prática de suplementação tem sido desacompanhada de um adequado processo de comunicação, informação e educação voltado à população beneficiária. Demonstrou que entre as mães predomina a falta de conhecimento sobre o programa e a Deficiência de Vitamina A. Revelou que algumas mães veem a vitamina A como a “vitamina do posto”, o que indica a concepção primária desse nutriente como medicamento e não como elemento constituinte dos alimentos. Apontou a concepção da vitamina A como vacina ou simplesmente como uma vitamina (de forma genérica), e, por fim, que essa vitamina é valorizada pelas mães, mesmo que, em alguns momentos, elas não compreendam sua importância. Conclui-se que é indispensável o desenvolvimento/fortalecimento de atividades educativas voltadas à população sobre a Deficiência de Vitamina A e as ações voltadas à sua prevenção/controle. Além disso, são necessárias reflexões sobre as representações que esse programa tem deixado para as famílias beneficiárias, por parte dos profissionais que atuam no seu desenvolvimento. DOI: 10.12957/demetra.2017.28065

This article aims to identify the fundamental individual and management skills for public environmental manager position, according to the researchers´ and undergraduate and graduate professors´ point of view. With a qualitative approach and from the opinion of thirteen researchers experts in the environmental field, it was found that the public officials´skills in relation to environmental management do not differ from private managers´skills. The researchers are emphatic when they say that public organizations should have a department which is responsible for the environment and therefore an environmental manager. However, this is an embryonic situation because the environmental issue is usually not seen strategically by organizations of the first sector.

A previsão de demanda é uma importante ferramenta de apoio à decisão no planejamento de sistemas de energia, fornecendo informações necessárias para que os especialistas do setor elétrico possam alocar os recursos disponíveis. Métodos baseados em inteligência computacional vêm sendo utilizados para previsão há mais de vinte anos. As Redes Neurais Artificiais (RNA) e a Lógica Fuzzy estão entre as técnicas mais utilizadas. Neste trabalho, foram desenvolvidos dois sistemas de previsão de demanda para uma subestação real, por meio de uma RNA e um sistema de inferência Fuzzy. O caso estudado foi a subestação de Itaporanga, localizada na Paraíba/Brasil, e os valores de potência ativa entre os anos de 2008 e 2013, obtidos por meio de medições de um sistema de aquisição e monitoramento de dados (SCADA), que formaram os dados das séries temporais.

Abstract Objective To investigate child growth, cognitive/language development, and their environmental and biological determinants. Methods This was a cross-sectional, predictive correlation study with all 92 children aged 24-36 months who attended the municipal early childhood education network in a town in the Vale do Jequitinhonha region, in 2011. The socioeconomic profile was determined using the questionnaire of the Associação Brasileira de Empresas de Pesquisa. The socio-demographicand maternal and child health profiles were created through a self-prepared questionnaire. The height-for-age indicator was selected to represent growth. Cognitive/language development was assessed through the Bayley Scale of Infant and Toddler Development. The quality of educational environments was assessed by Infant/Toddler Environment Scale; the home environment was assessed by the Home Observation for Measurement of the Environment. The neighborhood quality was determined by a self-prepared questionnaire. A multivariate linear regression analysis was performed. Results Families were predominantly from socioeconomic class D, with low parental education. The prevalence of stunted growth was 14.1%; cognitive and language development were below average at 28.6% and 28.3%, respectively. Educational institutions were classified as inadequate, and 69.6% of homes were classified as presenting a risk for development. Factors such as access to parks and pharmacies and perceived security received the worst score regarding neighborhood environment. Biological variables showed a greater association with growth and environmental variables with development. Conclusion The results showed a high prevalence of stunting and below-average results for cognitive/language development among the participating children. Both environmental and biological factors were related to growth and development. However, biological variables showed a greater association with growth, whereas environmental variables were associated with development.

Bancos de Alimentos são equipamentos públicos de segurança alimentar e nutricional destinados a captar alimentos perdidos e desperdiçados ao longo da cadeia produtiva e distribuir para pessoas em vulnerabilidade social e alimentar. Este estudo buscou verificar se a operacionalização do Programa de Aquisição de Alimentos interfere na eficácia quanto ao propósito precípuo de combate às perdas e desperdícios de alimentos de 10 Bancos de Alimentos públicos municipais de Minas Gerais. Estudo transversal descritivo, de enfoque avaliativo misto, integrando abordagens quantitativa e qualitativa. Avaliação externa, de natureza somativa e realizada “ex-post”. A coleta de dados se deu por entrevista estruturada, submetida à análise de conteúdo, e pesquisa documental retrospectiva para construção de indicadores de eficácia. Em 90% dos equipamentos verificou-se uma crescente participação do Programa de Aquisição de Alimentos em detrimento ao cumprimento do objetivo primordial de combate às perdas e desperdícios de alimentos, interferindo na eficácia dos Bancos de Alimentos de Minas Gerais. Mais estudos são necessários para verificar se há resultados semelhantes em outros Bancos de Alimentos do país.

Trata-se de apresentar as críticas de W. Benjamin ao uso do método da empatia na busca do conhecimento histórico. A empatia será associada ao tema da “revivência” em Dilthey e contraposta ao “intempestivo” nietzscheano. A empatia surgirá, então, como uma tentativa de conhecimento totalizante, que é incapaz do estranhamento necessário a um conhecimento que procura superar a nostalgia da totalidade idealista.

O objetivo do estudo foi avaliar a prevalência de deficiência de iodo em crianças de 6 a 71 meses em Novo Cruzeiro, Minas Gerais, Brasil. Foram analisadas 475 crianças alocadas por amostragem probabilística estratificada em relação às concentrações de iodo no sal de consumo familiar e excreção urinária de iodo. Observou-se excreção deficiente de iodo em 34,4% das crianças; entre as quais, 23,5% apresentaram deficiência leve; 5,9%, moderada; e 5%, grave. Diferença na distribuição da deficiência de iodo urinário foi constatada entre o meio urbano e rural (p < 0,001), registrando concentrações medianas de iodúria de 150,8µg/L e 114,3µg/L, respectivamente. Observou-se alta proporção de deficiência entre crianças cujo teor de iodo no sal de consumo encontrava-se abaixo da recomendação. A deficiência de iodo em Novo Cruzeiro não constitui problema de saúde pública segundo a Organização Mundial da Saúde (OMS), embora apresente prevalência ainda expressiva. A distribuição limítrofe de iodúria associada a baixos níveis de iodo no sal sugere que as ações de controle dessa carência ainda não são completas no país.The aim of this study was to evaluate the prevalence of iodine deficiency in children aged 6 to 71 months in Novo Cruzeiro, Minas Gerais State, Brazil. A total of 475 children, allocated by stratified probability sampling, were analyzed with respect to the iodine concentrations in the salt consumed by the family and urinary iodine. Iodine deficiency was verified in 34.4% of the children, of which 23.5% showed slight deficiency, 5.9% moderate and 5% serious deficiency. A difference in the distribution of iodine deficiency was observed between the urban and the rural environments (p < 0.001) where average urinary iodine concentrations of 150.8 and 114.3µg/L respectively were found. A greater proportion of iodine deficiency was observed among children where the proportion of iodine in the salt consumed was below the recommended level. Although expressive, iodine deficiency in Novo Cruzeiro is not a public health problem according to World Health Organization (WHO), The limitrophe distribution of the urinary iodine associated with low iodine levels in salt suggests that efforts to control this deficiency are not yet complete.

The glioblastoma multiforme is a agressive tumor in the brain. Despite aggressive multimodal treatment including surgical excision, local and systemic chemotherapy, median survival is in the range of 12 months. Patients with glioblastoma multiforme are considered to receive only palliative treatment with no hope of cure. Surgical resection is based on the premise that provides themaximum possible lengthen survival but with lower neurological deficit. Radiation therapy increases the duration of survival but is not curative and chemotherapeutic agents such as carmustine-based meta-analysis provide a discreet increase in survival but its use has not been widespread. We present a review of the current management of glioblastoma multiforme to the staff of Health SciencesRESUMENEl glioblastoma multiforme es el más común y más agresivo tumor del sistema nervioso central y se asocia con la mas baja sobrevida de todos los canceres en humanos. A pesar del tratamiento agresivo multimodal que comprende la resección quirúrgica, quimioterapia local y sistémica, la sobrevida media está en el rango de los 12 meses. Los pacientes con glioblastomas multiformes son considerados a recibir únicamente tratamiento de carácter paliativo sin ninguna esperanza de curación. La resección quirúrgica se basa en la premisa de la máxima posible que provea y alargue la sobrevida pero con el menor déficit neurológico. La radioterapia incrementa la duración de la sobrevida pero no es curativa y los agentes quimioterapéuticos como la carmustina ofrecen, basado en metanálisis, un discreto incremento en la sobrevida pero su uso todavía no se ha generalizado. Presentamos una revisión del estado actual del manejo del glioblastoma multiforme para el personal de ciencias de la salud

Iron deficiency anemia is one of the most common nutritional disorders worldwide. The aim was to identify the prevalence and incidence of anemia in children and to identify predictors of this condition, including intestinal parasites, social, nutritional and environmental factors, and comorbidities. A population-based cohort study was conducted in a sample of 414 children aged 6-71 months living in Novo Cruzeiro in the Minas Gerais State. Data were collected in 2008 and 2009 by interview and included socio-economic and demographic information about the children and their families. Blood samples were collected for testing of hemoglobin, ferritin and C-reactive protein. Anthropometric measurements and parasitological analyses of fecal samples were performed. To identify risk factors associated with anemia multivariate analyses were performed using the generalized estimating equations (GEE). In 2008 and 2009, respectively, the prevalence rates of anemia were 35.9% (95%CI 31.2-40.8) and 9.8% (95%CI 7.2-12.9), the prevalence rates of iron deficiency were 18.4% (95%CI 14.7-22.6) and 21.8% (95%CI 17.8-26.2), and the incidence rates of anemia and iron deficiency were 3.2% and 21.8%. The following risk factors associated with anemia were: iron deficiency (OR = 3.2; 95%CI 2.0-.5.3), parasitic infections (OR = 1.9; 95%CI 1.2-2.8), being of risk of or being a low length/height-for-age (OR = 2.1; 95%CI 1.4-3.2), and lower retinol intake (OR = 1.7; 95%CI 1.1-2.7), adjusted over time. Nutritional factors, parasitic infections and chronic malnutrition were identified as risk factors for anemia. These factors can be verified in a chronic process and have been classically described as risk factors for these conditions.

Moving from his peculiar way of mingling poetry and natural philosophy, his composing lyrics with the condensation of good prose and his writing essays in a poetical language, these pages investigate the ambiguous attitude towards the natural world and, in particular, towards the animal dimension that marks Abraham Cowley’s writings. Close to Andrew Marvell, Richard Lovelace, John Evelyn and Samuel Pepys, for instance, Cowley seems to be torn between Descartes’s mechanistic approach and Gassendi’s ‘animistic’ theories, Republican ideals and monarchic values, classic culture and modern science: the poet celebrates and worships the natural world in its wholeness, identifies humanity (and wit) with animals and plants, obliquely associates a mouse with Charles II and, by displaying a paradoxical treatment of animals that do not belong to the poetical tradition, sheds light on the ‘split’ spirit of his age.

A produção científica é um recurso indispensável para promover o desenvolvimento da ciência. Este artigo tem como objetivo refletir sobre a produção científica da Geografia Médica e da Saúde, para isso discute a produção de artigos científicos. Realizou-se busca na base de dados da Revista Hygeia e como método de análise o tratamento bibliométrico. As regiões sudeste, centro-oeste e sul são aquelas que mais produzem artigos científicos, destacando-se a Universidade Estadual de São Paulo e a Universidade Federal de Uberlândia. As principais doenças e enfermidades identificadas são a dengue, as doenças respiratórias, doença de Chagas, leptospirose, hanseníase e malária. Conclui-se que os indicadores bibliométricos são eficientes quando os dados são detalhadamente trabalhados e eficazes quando cautelosamente analisados, esse conjunto permite um diagnóstico do real, portanto, dos temas e enfermidades emergentes no estudo da Geografia Médica e da Saúde.

The Sloan Digital Sky Survey has allowed us to increase the number of known white dwarfs by a factor of five and consequently the number of known pulsating white dwarfs also by a factor of five. It has also led to the discovery of new types of variable white dwarfs, as the variable hot DQs, and the pulsating Extremely Low Mass white dwarfs. With the Kepler Mission, it has been possible to discover new phenomena, the outbursts present in a few pulsating white dwarfs.

A microbacia hidrográfica de Val-de-Cães situada no Município de Belém apresenta como característica a densa ocupação urbana, representada por ocupações clandestinas, conjuntos residenciais e por áreas institucionais. O presente estudo analisa os impactos provenientes pelas principais formas de ocupação e uso da microbacia de Val-de-Cães, utilizando como indicador a qualidade das águas superficiais do corpo hídrico. As análises das águas foram realizadas em dois períodos, um chuvoso (fevereiro) e outro seco (agosto), sendo determinados os seguintes parâmetros: turbidez, condutividade, cor, pH, OD, temperatura, componentes nitrogenados, DBO, metais, óleos e graxas e coliformes totais e fecais. A água do igarapé revelou valores elevados na jusante do igarapé, possivelmente pela influência direta da baia do Guajará, para o pH, óleos e graxas, coliformes e DBO. Na nascente os parâmetros de coliformes totais e DBO apresentam valores que são considerados elevados em relação aos demais pontos de coleta, mas é o local que apresenta considerável número de palafitas e pouca vegetação. A presença de efluentes domésticos e esgotos são retratados principalmente pela quantidade de coliformes, óleos e graxas, turbidez e teor de fósforo nas amostras coletadas em ambos os períodos e pelo grande número de pontos de descargas que aumentam a cada dia.

Abstract Background The al-Andalus physical activity intervention study is a randomised control trial to investigate the effectiveness of a land- and water-based exercise intervention for reducing the overall impact of fibromyalgia (primary outcome), and for improving tenderness and pain-related measures, body composition, functional capacity, physical activity and sedentary behaviour, fatigue, sleep quality, health-related quality of life, and cognitive function (secondary outcomes) in women with fibromyalgia. Methods/Design One hundred eighty women with fibromyalgia (age range: 35-65 years) will be recruited from local associations of fibromyalgia patients in Andalucía (Southern Spain). Patients will be randomly assigned to a usual care (control) group (n = 60), a water-based exercise intervention group (n = 60) or a land-based exercise intervention group (n = 60). Participants in the usual care group will receive general physical activity guidelines and participants allocated in the intervention groups will attend three non-consecutive training sessions (60 min each) per week during 24 weeks. Both exercise interventions will consist of aerobic, muscular strength and flexibility exercises. We will also study the effect of a detraining period (i.e., 12 weeks with no exercise intervention) on the studied variables. Discussion Our study attempts to reduce the impact of fibromyalgia and improve patients' health status by implementing two types of exercise interventions. Results from this study will help to assess the efficacy of exercise interventions for the treatment of fibromyalgia. If the interventions would be effective, this study will provide low-cost and feasible alternatives for health professionals in the management of fibromyalgia. Results from the al-Andalus physical activity intervention will help to better understand the potential of regular physical activity for improving the well-being of women with fibromyalgia. Trial registration ClinicalTrials.gov ID: NCT01490281

A characterization for the entire solutions of a nonlinear inequality, which has a natural interpretation in terms of certain nonflat Robertson-Walker spacetimes, is given. As an application, new Calabi-Bernstein type problems are solved.

Abstract Objectives: to determine the fatty acid composition of mature milk of nursing mothers and its distribution according to some maternal variables. Methods: this is a cross-sectional observational epidemiological study based on the eva-luation of the fatty acid profile of mature human milk. Samples of mature breast milk were taken from 106 nursing mothers, by manual milking and who were after the 5th postpartum week. The milk fat extraction was carried out by using the Bligh and Dyer method and methy-lated with 0.25 mol/L sodium methoxide in methanol diethyl ether. The fatty acid of the milk profile was determined by a Gas Chromatograph equipped with a flame ionization detector. Results: among the saturated fatty acids, the highest values were observed for palmitic (C16:0), stearic (C18:0), myristic (C14:0) and lauric (C12:0) fatty acids, respectively. Among the monounsaturated fatty acids, there was a higher contribution of oleic (C18:1) and palmi-toleic (C16:1) fatty acids, respectively. The total essential fatty acids (linoleic and α-linolenic) was 14.94%. Conclusions: a low content of essential fatty acids in the breast milk of the nursing mothers was observed in the present study, which are important for infant growth and deve-lopment. We suggest the need to implement nutrition education strategies aimed for pregnant women and nursing mothers who should be advised to eat healthier foods.

Infective endocarditis (IE) is a well-known condition, but certain manifestations, such as Eustachian valve endocarditis (EVE), remain rare. This report presents a case of EVE in a 66-year-old male with no apparent risk factors. EVE is a form of right-sided endocarditis, often associated with intravenous drug use, yet it can occur in patients without traditional risk factors. The patient presented with a constellation of symptoms, including lightheadedness, dyspnea, generalized weakness, and fever. Diagnostic workup revealed multiple complications, including liver abscesses, pulmonary nodules, and spinal osteomyelitis. EVE was confirmed through transesophageal echocardiography (TEE), highlighting multiple Eustachian valve vegetations. Blood cultures identified Bacteroides fragilis as the causative agent. The patient received appropriate antimicrobial therapy, underwent drainage of liver abscesses, and was started on therapeutic anticoagulation for thrombophlebitis. A favorable clinical response was observed, and the patient was discharged for continued outpatient follow-up. This case underscores the importance of considering atypical forms of endocarditis, such as EVE, even in patients lacking traditional risk factors. The diagnostic utility of TEE and the management of complications, including liver abscesses and thrombophlebitis, are discussed. Awareness of such presentations is essential for timely diagnosis and effective treatment., Competing Interests: Conflict of interest: There is no conflict of interest., (© 2024 Greater Baltimore Medical Center.)

Aortic stenosis is a common valvular disease that is expected to become more prevalent with the aging population. It is often undiagnosed in socioeconomically deprived groups. Diagnosis relies on echocardiography, and additional imaging techniques such as cardiac computed tomography (CCT) and cardiovascular magnetic resonance (CMR) are increasingly used. Surgical aortic valve replacement is the standard treatment, except for high-risk cases where TAVR is recommended. Subvalvular aortic stenosis (SAS) is the second most common cause of left ventricular outflow tract obstruction. This case report highlights a 72-year-old Hispanic lady with both valvular and subvalvular aortic stenosis, emphasizing the need for specialized care and surgical intervention. Early identification, accurate assessment, and appropriate intervention are crucial for improving outcomes in aortic stenosis and subvalvular stenosis cases., Competing Interests: Conflict of interest: There is no conflict of interest., (© 2024 Greater Baltimore Medical Center.)

Acute coronary syndrome (ACS) is a serious medical condition caused by cardiac muscle ischemia, which can lead to myocardial injury or necrosis. EKG is a critical diagnostic tool for patients with suspected ACS, as it can determine the vascular territory and guide therapy. However, there are various non-cardiac causes of EKG changes that mimic ACS and can lead to misdiagnosis and inappropriate management. We present the case of a 57-year-old lady with an extensive past medical history of coronary artery disease (CAD) who presented to our institution unresponsive and pulseless secondary to a perforated viscus and was found to have ST-segment elevations in inferior leads on the EKG., Competing Interests: Conflict of interest: There is no conflict of interest., (© 2024 Greater Baltimore Medical Center.)

Diverticular disease is a condition that ranges from asymptomatic disease to severe complications, such as abscesses, fistulas, and perforations. It is prevalent in Western countries, with up to 60% of people aged 60 having diverticula. In Asian countries, the prevalence is lower, ranging from 13 to 25%. Diverticulitis can occur in any location of the diverticula, with increasing incidence with age. Complications occur in 12% of patients with diverticulitis, with phlegmon or abscesses being the most common. Perforation is a life-threatening complication with a 1-year mortality rate of 20%. Recent studies suggest that chronic inflammation and alteration of the gut microbiome may play a role in diverticulitis, leading to a less aggressive and conservative approach to treatment. Even though diverticular disease represents a very common clinical entity, diverticula located in the transverse colon it is an extremely rare presentation. We present the case of a 39-year-old female with a history of multiple medical conditions who presented to the Emergency Room (ER) with severe diffuse abdominal pain predominantly in the right lower quadrant associated with shortness of breath. Upon physical examination, she was found to have severe pain, bilateral rhonchi, and a diffusely tender abdomen with guarding without rebound tenderness. Lab analysis showed leukocytosis, and a CT scan of the abdomen and pelvis revealed acute transverse diverticulitis which was treated medically., Competing Interests: Conflicts of interest: There is no conflict of interest., (© 2024 Greater Baltimore Medical Center.)

Systemic Lupus Erythematosus represents a chronic autoimmune disorder characterized by multiorgan involvement. Lupus myocarditis is a rare presentation of one of the cardiac complications of lupus with an incidence of 3-9%. It usually presents with non-specific symptoms such as dyspnea, orthopnea, chest pain, pedal edema, fever, diaphoresis, paroxysmal nocturnal dyspnea, nausea, vomiting, or palpitations. Even though endomyocardial biopsy is considered the gold standard diagnostic approach, other non-invasive diagnostic alternatives including cardiac magnetic resonance (CMR) have been studied. Therapeutic interventions may range from high-dose steroids, and IVIG, to the most advanced strategies such as mechanical circulatory support including VenoArterial Extracorporeal Membrane Oxygenation (VA-ECMO), and Impella, among others., Competing Interests: Conflict of interest: There is no conflict of interest., (© 2024 Greater Baltimore Medical Center.)

Prosthetic valve endocarditis is a serious complication following valve replacement surgery, with the development of aortic root abscess being a catastrophic manifestation. We present a case of a 71-year-old female with a bioprosthetic aortic valve who presented with shortness of breath. Echocardiographic findings revealed vegetation on the prosthetic aortic valve with a periaortic, annular abscess. Given the patient's comorbidities and high surgical risk, conservative management with antibiotics was chosen. The patient responded well to antibiotic therapy and was discharged with long-term antibiotic treatment. Prosthetic valve endocarditis, particularly with periaortic abscess formation, is associated with significant morbidity and mortality. Early diagnosis and appropriate management are crucial for improving outcomes., Competing Interests: Conflict of interest: There is no conflict of interest., (© 2024 Greater Baltimore Medical Center.)

Neonatal hypoxia-ischemia (HI) is a major cause of perinatal death and long-term disabilities worldwide. Post-ischemic neuroinflammation plays a pivotal role in HI pathophysiology. In the present study, we investigated the temporal dynamics of microglia (CX3CR1 GFP/+ ) and infiltrating macrophages (CCR2 RFP/+ ) in the hippocampi of mice subjected to HI at postnatal day 9. Using inflammatory pathway and transcription factor (TF) analyses, we identified a distinct post-ischemic response in CCR2 RFP/+ cells characterized by differential gene expression in sensome, homeostatic, matrisome, lipid metabolic, and inflammatory molecular signatures. Three days after injury, transcriptomic signatures of CX3CR1 GFP/+ and CCR2 RFP/+ cells isolated from hippocampi showed a partial convergence. Interestingly, microglia-specific genes in CX3CR1 GFP/+ cells showed a sexual dimorphism, where expression returned to control levels in males but not in females during the experimental time frame. These results highlight the importance of further investigations on metabolic rewiring to pave the way for future interventions in asphyxiated neonates., Competing Interests: V.M.L. is CEO and shareholder of HepaPredict AB, as well as co-founder and shareholder of PersoMedix AB., (© 2024 The Author(s).)

Acute myocardial infarction can result in various mechanical complications, although they have become rare with the advent of reperfusion therapies. Among these complications, ventricular septal rupture (VSR) and left ventricular aneurysm (LVA) are infrequent but life-threatening conditions associated with high morbidity and mortality. We present a rare case of a 67-year-old male with acute myocardial infarction who developed concomitant apical LVA and ventricular septal rupture., Learning Points: Mechanical complications of myocardial infarction, such as a ventricular septal rupture (VSR) and left ventricular aneurysm (LVA), are rare but life-threatening.Early diagnosis is critical. A ventricular septal defect (VSD) requires immediate surgical closure, while surgery for LVA is only considered in specific cases such as chest pain or thromboembolism.Diagnostic tools such as echocardiography and left ventriculography play a vital role in identifying and characterising these complications, enabling timely treatment decisions., Competing Interests: Conflicts of Interests: The Authors declare that there are no competing interests., (© EFIM 2024.)

Novel approaches in higher education are needed to reverse underrepresentation of racial/ethnic groups in science, technology, engineering, mathematics, and medicine (STEMM). Building on theoretical frameworks for practice in diverse learning environments, this study provides evidence for Inclusive Science as a conceptual model that reflects initiatives intended to diversify biomedical research training for undergraduates. Using multiple case study design and cross-case analysis, we analyzed data from 10 higher education sites that were awarded the Building Infrastructure Leading to Diversity (BUILD) grant funded by the National Institutes of Health (NIH). We identified the following dimensions of the Inclusive Science model: promoting participation of diverse researchers; introducing diversity innovations in science and research curriculum; improving campus climate for diversity; providing tangible institutional support; creating partnerships with diverse communities; and integrating students' social identities with science identity. We illustrate each dimension of the model with examples of campus practices across BUILD sites. While many may doubt that science can be responsive to diversity, the interventions developed by these campuses illustrate how colleges and universities can actively engage in culturally responsive practices in STEMM undergraduate training that integrate trainees' identities, knowledge of diverse communities, and create a greater awareness of the climate for diversity that affects student training and outcomes. Implications include culturally responsive strategies that many more higher education institutions can employ to support scientific career training for historically excluded groups., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Cobian et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

A left ventricular pseudoaneurysm (LVP) is defined as an outpouching contained by the surrounding pericardium. Clinical presentation is often unspecific with patients presenting with chest pain, dyspnea, symptoms consistent with heart failure, and post-myocardial infarction. Cardiac magnetic resonance imaging represents an important tool for differentiating a pseudoaneurysm from a true aneurysm. Furthermore, multiple imagining modalities are available, including transesophageal and transthoracic echocardiogram and contrast ventriculography, which remains the gold standard diagnostic technique. Early recognition and prompt surgical management are of utmost importance in patients with acute and symptomatic LVP. On the other hand, medical management may be considered in patients with chronic and small pseudoaneurysms. Here, we are presenting a 74-year-old lady who presented with chest pain and was found to have a chronic and small LVP which was managed conservatively., Competing Interests: Conflict of interest: There is no conflict of interest., (© 2023 Greater Baltimore Medical Center.)

Brugada syndrome is an inherited disorder characterized by a channelopathy of cardiac sodium, potassium, and calcium channel. The pathophysiology of this disorder is not completely elucidated yet, however, most of the reported cases are caused by a pathogenic alteration in the SCN5A gene, leading to the malfunction of cardiac sodium channels. Several stressors are well known to unmask this pathology including fever and electrolytes imbalance. Three ECG patterns are frequently described in the literature, type 1, type 2, and type 3. However, only the type 1 pattern is considered diagnostic of Brugada syndrome in the appropriate clinical context. Therapeutic strategies can range from conservative medical management with antiarrhythmic medications to Automatic Implantable Cardioverter Defibrillator (AICD) placement. Prompt recognition is of utmost importance since this pathology can rapidly evolve into life-threatening arrhythmias and sudden cardiac death. Here we present a case of a 22-year-old male who presented after a syncopal episode and was found to have Brugada syndrome in the setting of Influenza A infection., Competing Interests: Conflict of interest There is no conflict of interest., (© 2023 Greater Baltimore Medical Center.)

Several invasive mosquito species that are nuisances or of medical and veterinary importance have been introduced into the Southeastern region of the USA, posing a threat to other species and the local ecosystems and/or increasing the risk of pathogen transmission to people, livestock, and domestic pets. Prompt and effective monitoring and control of invasive species is essential to prevent them from spreading and causing harmful effects. However, the capacity for invasive mosquito species surveillance is highly variable among mosquito control programs in the Southeast, depending on a combination of factors such as regional geography and climate, access to resources, and the ability to interact with other programs. To facilitate the development of invasive mosquito surveillance in the region, we, the Mosquito BEACONS (Biodiversity Enhancement and Control of Non-native Species) working group, conducted a survey on the capacities of various public health agencies and pest control agencies engaged in mosquito surveillance and control in seven Southeastern states (Alabama, Florida, Georgia, Louisiana, Mississippi, North Carolina, and South Carolina). Ninety control programs completed the survey, representing an overall response rate of 25.8%. We report key findings from our survey, emphasizing the training and resource needs, and discuss their implications for future invasive mosquito surveillance and control capacity building. By increasing communication and collaboration opportunities (e.g., real-time sharing of collection records, coordinated multistate programs), the establishment of Mosquito BEACONS and the implementation of this survey can accelerate knowledge transfer and improve decision support capacity in response to or in preparation for invasive mosquito surveillance and can establish infrastructure that can be used to inform programs around the world., (Copyright © 2023 by The American Mosquito Control Association, Inc.)

Left Ventricular Non-Compaction Cardiomyopathy (LVNC) is a rare myocardial disorder characterized by abnormal myocardial tissue formation in which the left ventricular wall appears to be trabecular with prominent intertrabecular recesses. The diagnosis of LVNC is predominantly reliant on cardiac imaging, namely thoracic echocardiography, however, cardiac MRI is indicated in conditions in which echocardiography is inconclusive. Diagnostic criteria for both echocardiography and cardiac MRI differ, however, the general principle of diagnosis is a comparison of the thickness of non-compacted to compacted myocardial tissue. The management of LVNC is nearly identical to that of Heart Failure with reduced Ejection Fraction (HFrEF), however, anticoagulation is an additional measure of management to the thrombogenic nature of non-compacted myocardial tissue. Here, we discuss a case of LVNC and the current data on its management., Competing Interests: Conflict of interest There is no conflict of interest., (© 2023 Greater Baltimore Medical Center.)